$149.12–$167.95
Both describe simple repair in the same anatomic group. Choose 12011 for a repaired length of 2.5 cm or less and 12013 for the next length level.
On this page
CMS RVU26D · Effective 2026-10-01
12011 Wound repair Medicare reimbursement rates in Washington
Reports simple, superficial wound closure on the face or related sites when the repaired length is 2.5 cm or less. Compare 12011 office and facility rates across CMS payment localities in Washington.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 12011 in Washington?
Washington has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$143.38–$162.01
2 of 2 localities have a supported rate.
Facility setting
$53.70–$57.50
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Wound repair
About 12011: Simple facial wound repair, 2.5 cm or less
Reports simple, superficial wound closure on the face or related sites when the repaired length is 2.5 cm or less.
This code describes simple closure of a superficial wound involving the face, ears, eyelids, nose, lips, or mucous membranes. The repair is generally a single-layer closure of skin or mucosal edges, such as a small facial laceration closed with sutures or tissue adhesive. Emergency clinicians, primary care practitioners, and surgeons commonly perform these repairs in emergency departments, offices, and urgent care settings.
Choose the code based on the wound’s location, repair complexity, and documented length. Record the site, length, depth, and closure method; combine lengths of simple repairs in the same anatomic grouping when selecting the length level. A layered closure or repair requiring more than simple closure may call for an intermediate repair code. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgery and team surgery are not permitted.
CMS billing rules for 12011
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.04 · 25%
- Practice expense (office) RVU2.91 · 70%
- Malpractice RVU0.23 · 6%
80.7K
Medicare services in 2024 · #630 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
12011 compared with similar codes
Office rates for Washington, from the same CMS release.
$117.08–$132.44
This code is for simple repairs of the face and related sites. Code 12001 covers specified scalp, neck, axilla, genital, trunk, and extremity sites instead.
$268.78–$304.17
12011 describes simple superficial closure. Consider 12031 when the documented repair is intermediate in complexity and its anatomic site and length fit that code.
Compare 12011 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Rest Of Washington →
Office / nonfacility
$143.38
Facility
$53.70
Seattle (King Cnty) →
Office / nonfacility
$162.01
Facility
$57.50
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12011 billing questions
How is 12011 distinguished from 12013?
Both cover simple repairs in the same anatomic group. Use 12011 when the documented repaired length is 2.5 cm or less; 12013 is for the next length level.
Can lengths of multiple facial wounds be combined?
Combine lengths of simple repairs in the same anatomic grouping when determining the length level. Document each wound’s site and measurement.
When is an intermediate repair code more appropriate?
Use an intermediate repair code when the documented repair involves greater complexity, such as layered closure, rather than a simple superficial closure.
Should modifier 50 be appended for wounds on both sides of the face?
No. Modifier 50 is inappropriate for this code; select the code using the applicable anatomic grouping and repaired length.
Does the code include same-day care around the repair?
Yes. Its 0-day global period includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be reported for this repair?
Medicare payment for an assistant at surgery is restricted for this code. Co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,40012006,,Rpr s/n/a/gen/trk20.1-30.0cm,A,,2.33,4.35,,0.43,,0.51,7.19,3.27,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,40112007,,Rpr s/n/ax/gen/trnk >30.0 cm,A,,2.83,4.21,,0.56,,0.62,7.66,4.01,0,000,0.00,0.00,0.00,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,4021200F,,Seizure type& frequ docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,40312011,,Rpr f/e/e/n/l/m 2.5 cm/<,A,,1.04,2.91,,0.36,,0.23,4.18,1.63,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,40412013,,Rpr f/e/e/n/l/m 2.6-5.0 cm,A,,1.19,2.90,,0.21,,0.27,4.36,1.67,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,40512014,,Rpr f/e/e/n/l/m 5.1-7.5 cm,A,,1.53,3.27,,0.27,,0.36,5.16,2.16,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,40612015,,Rpr f/e/e/n/l/m 7.6-12.5 cm,A,,1.93,3.94,,0.33,,0.44,6.31,2.70,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00